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Medical Arts Press® Dental Registration and History Form; Green Marble

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Item # 901-20638
  Model # 20638RL
Medical Arts Press® Dental Registration and History Form; Green Marble
$40.99 Pack When you buy 8+

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250 EACH = 1 PACK
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Qty 1 2-3 4-7 8+
Price $52.99 $48.99 $44.99 $40.99
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Price per each: $0.21 $0.20 $0.18 $0.16
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Description
  • HIPAA compliant insurance authorization
  • Help ensure reimbursement and improve risk management
  • Collects printed name and relationship to patient
  • Medication lists requests correlating diagnosis
  • Screens for artificial heart valves, artificial joints, heart murmur, mitral valve prolapse and pacemaker
  • 250 sheets per film wrapped pack
  • Size: 8-1/2x11"
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